DOCSLIB.ORG

Anesthetic and Cardio-Pulmonary Effects of Propofol Or Alfaxalone with Or Without Midazolam Co-Induction in Fentanyl Sedated Dogs by Penting Liao

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Anesthetic and Cardio-Pulmonary Effects of Propofol Or Alfaxalone with Or Without Midazolam Co-Induction in Fentanyl Sedated Dogs by Penting Liao Anesthetic and Cardio-pulmonary Effects of Propofol or Alfaxalone with or without Midazolam Co-Induction in Fentanyl Sedated Dogs by PenTing Liao A Thesis presented to The University of Guelph In partial fulfilment of requirements for the degree of Doctor of Veterinary Science in Clinical Studies Guelph, Ontario, Canada © PenTing Liao, August, 2016 ABSTRACT Anesthetic and Cardio-pulmonary Effects of Propofol or Alfaxalone with or without Midazolam Co-Induction in Fentanyl Sedated Dogs For Diagnostic Imaging PenTing Liao Advisor: University of Guelph, 2016 Dr. Melissa Sinclair This thesis describes a prospective, randomized, incomplete Latin-square crossover, blind trial to investigate the effects of midazolam (M) as a co-induction agent in dogs induced and maintained with propofol (P) or alfaxalone (A) for diagnostic imaging. The quality of induction and recovery, induction and maintenance dose requirements for P or A, ease of maintenance using total intravenous anesthesia (TIVA), and cardio-pulmonary effects were determined in ten dogs assigned to P-S: P with saline (S); A-S: A with S; P-M: P with M; A-M: A with M. Fentanyl (7 µg kg-1, IV) was administered 10 minutes prior to an IV bolus of P (1 mg kg-1) or A (0.5 mg kg-1) followed by M (0.3 mg kg-1, IV) or S and additional boluses of P or A for intubation, followed by P or A TIVA during imaging. The induction quality was significantly better in A-M versus A-S, P-M versus P-S, and A-M versus P-S. The induction dose was significantly lower in P-M versus P-S, and A-M versus A-S. The TIVA rate with P-M was significantly lower than P-S but similar between A-M and A-S. Sedation, extubation and recovery quality, and TIVA duration were similar between treatments. Time to standing was significantly longer for A than P, but was similar within A or P treatments. After induction, heart rate (HR) was significantly higher in A-M than A-S and P-S. During imaging, HR of A-S and A-M were significantly higher than P-S. Before recovery, HR of A-M was significantly higher than P-S. Systolic blood pressure of A-S was significantly higher than A-M and P-M. There was no significant treatment difference for mean or diastolic blood pressure, cardiac index (CI), respiratory rate, occurrence of apnea, end-tidal CO2, and blood gas values. However, CI and HR significantly decreased after imaging compared to other phases. Midazolam improved the quality and reduced the required dose for both P and A induction, and reduced TIVA rate of P. There was no significant cardiopulmonary difference identified between treatments despite co-induction with M. The decrease in CI and HR after imaging warrants close monitoring during recovery. ACKNOWLEDGEMENTS First, I would like to thank my dad, mom, brother and two sisters who support me unconditionally for the past 30 years. Second, I would like to thank Drs. Melissa Sinclair, Alex Valverde, Conny Mosley and Craig Mosley for their clinical and academic mentoring. Special thank to my supervisor Dr. Sinclair who made the whole residency/DVSc training possible for me and Dr. Sawyer who encouraged and assisted me to apply in the first place. Third, I would like to thank my resident mates Andrea, Alicia and Rodrigo for helping each other out whenever needed and learned from each other. Fourth, I would like to thank all the veterinarians and technicians in OVC especially anesthesia section: Emily, Lucy, Cindy, Andrea, Ines, Rob, Megan, Nick, Jen, Shirley for their patience and kindness. Fifth, I would like to thank my neighbors and resident mates Miranda, Gonzalo and Rames whose presence made last three years more fun and pleasant. Last, I would like to thank everyone I meet along the way of my life. I am who I am because of all of you. iv TABLE OF CONTENTS ACKNOWLEDGEMENTS………………………………………………………………...iv TABLE OF CONTENTS…………………………………………………………………....v DECLARATION OF WORK PERFORMED…...………………………………...….…. x LIST OF TABLES……………………………………………………...…………………. xi LIST OF FIGURES……………………………………………………………………….xiii CHAPTER I GENERAL LITERATURE REVIEW……………………………………………………..…1 Introduction and objectives…………….……….………………………………………..…..1 Study goals and statement of hypothesis……..………………………………………….…..3 Literature review……………………………..………………………………………………4 Pre-anesthetic sedation…………………….………………………………………………...4 Injectable induction agents………………….……………………………………………….7 Alfaxalone……………………….……………………………………………….….7 Physical and chemical properties………….………………………….……..8 Pharmacology: Central nervous system effects………………………….….9 Cardiovascular effects…………………………………………………..…10 Respiratory effects………………………………………………………...12 Induction dosage and quality……………………………………………...14 Propofol…………………………………………………………………………...14 Physical and chemical properties………………………………………....14 Pharmacology: Central nervous system effects……………………….…..15 Cardiovascular effects………………………………………………….…15 v Respiratory effects………………………………………………………...16 Induction dosage and quality………………………………………………17 The use of co-induction agents…………………………………………………….………18 Advantages…………………………………………………………………...…....18 Disadvantages…………………………………………………….………………..19 Drugs commonly used as co-induction agents…………………………………….19 Benzodiazepines…………………………………………………………...19 Lidocaine…………………………………………………………………..23 Ketamine…………………………………………………………………..24 Total intravenous anesthesia (TIVA)..……………………………………………………..25 History of TIVA……………………………………………………………...…....25 TIVA compared to inhalant anesthesia………………………………………….....26 Use of alfaxalone as a total intravenous agent…………………………………….27 Pharmacokinetics of alfaxalone………………………………………...…27 Cardiovascular and respiratory effects of alfaxalone TIVA…………….…27 Use of propofol as a total intravenous agent…………………………………...….28 Pharmacokinetics of propofol…………………………………………..…28 Cardiovascular and respiratory effects of propofol TIVA…………………28 Recovery characteristics from alfaxalone and propofol…………………………..29 Recovery quality of alfaxalone………………………………………...….29 Recovery time with alfaxalone………………………………………..…..29 Recovery quality of propofol…………………………………………..….30 Recovery time with propofol………………………………………….…..30 Comparison between alfaxalone and propofol for induction and maintenance…..31 Cardiac output (CO) measurement in research……………………………………………31 vi Definition and importance of cardiac output……………………………………...32 Techniques of cardiac output measurement………………………………………32 Direct Fick method………………………………………………….……33 Indicator method………………………………………………………….34 Pulse contour method……………………………………………….…….37 Ultrasound-based method…………………………………………………39 Thoracic electrical impedance method………………………………...…40 Validation in dogs…………………………………………………………………40 Direct Fick method…………………………………………………...…..40 Thermodilution method………………………………………………...…41 Lithium dilution method………………………………………………..…41 Pulse contour methods……………………………………………….……42 PulseCO…………………………………………………...………42 PiCCO…………………………………………………………..…43 FloTrac/Vigileo……………………………………………………43 Indirect Fick method………………………………………………………44 NICO………………………………………………………………44 Thoracic electrical impedance method……………………………………44 Ultrasound-based method…………………………………………………45 Summary of cardiac output methods…………………………………………...…46 Literature review summary……………………………………………………………..…47 References…………………………………………………………………………………48 CHAPTER II INDUCTION DOSE AND RECOVERY QUALITY OF PROPOFOL AND ALFAXALONE vii WITH OR WITHOUT MIDAZOLAM CO-INDUCTION FOLLOWED BY TOTAL INTRAVENOUS ANESTHESIA IN DOGS…………….………………………………..74 Summary………………………………………………………………………………..…74 Introduction……………………………………………………………………….………76 Materials and methods…………………………………………………………...….……78 Results……………………………………………………………………………...…..…85 Discussion…………………………………………………………………………………88 References……………………………………………………………………...…………97 Appendices……………………………………………………………………………….106 CHAPTER III CARDIO-PULMONARY EFFECTS OF PROPOFOL OR ALFAXALONE WITH OR WITHOUT MIDAZOLAM CO-INDUCTION FOLLOWED BY TOTAL INTRAVENOUS ANESTHESIA IN FENTANYL SEDATED DOGS…………………………………….111 Summary………………………………………………………………………………...111 Introduction……………………………………………………………………………...113 Materials and methods………………………………………………………………..…115 Results…………………………………………………………………………………...123 Discussion……………………………………………………………………………….127 References…………………………………………………………………………….…131 CHAPTER IV GENERAL DISCUSSION AND CONCLUSIONS……………………………………..145 Limitations of the study……………………………………………………………….…147 Strengths of the study…………………………………………………………………….149 viii Areas for future research…………………………………………………………………150 References……………………………………………………………………………..…152 APPENDICES…………………………………………………………………………....154 ix DECLARATION OF WORK PERFORMED The authors’ contribution is as follow: PenTing Liao: Data collection, statistical analysis and manuscript preparation; Melissa Sinclair: Study design and funding application, data collection, video scoring of recovery and manuscript review and revision; Alexander Valverde: Data collection, video scoring of recovery and manuscript review and revision; Conny Mosley: Manuscript review, video scoring of recovery and revision; Heather Chalmers: Manuscript review and revision; Shawn Mackenzie: Data collection and manuscript review and revision; Brad Hanna: Manuscript review and revision. x LIST OF TABLES TABLE 1. SUMMARY OF CARDIOVASCULAR EFFECTS OF INDUCTION WITH ALFAXALONE IN DOGS ................................................................................................................................. 70 TABLE 2. INDUCTION DOSES AND QUALITY WITH ALFAXALONE ............................................ 72 TABLE 3. DESCRIPTIVE QUALITY SCORES FOR SEDATION (SEDQ) (0-NONE TO 3-PROFOUND), TIME
Load more

Recommended publications
  • CHRONIC PAIN in CATS Recent Advances in Clinical Assessment
    601_614_Monteiro_Chronic pain3.qxp_FAB 12/06/2019 14:59 Page 601 Journal of Feline Medicine and Surgery (2019) 21, 601–614 CLINICAL REVIEW CHRONIC PAIN IN CATS Recent advances in clinical assessment Beatriz P Monteiro and Paulo V Steagall Negative impacts of chronic pain Practical relevance: Chronic pain is a feline health and welfare issue. It has Domestic animals may now have a long life expectancy, given a negative impact on quality of life and advances in veterinary healthcare; as a consequence, there is an impairs the owner–cat bond. Chronic increased prevalence of chronic conditions associated with pain. pain can exist by itself or may be Chronic pain affects feline health and welfare. It has a negative impact associated with disease and/or injury, on quality of life (QoL) and impairs the owner–cat bond. including osteoarthritis (OA), cancer, and oral Nowadays, chronic pain assessment should be considered a funda- and periodontal disease, among others. mental part of feline practice. Clinical challenges: Chronic pain assessment Indeed, lack of knowledge on is a fundamental part of feline practice, but can be Chronic pain-related changes the subject and the use of appro- challenging due to differences in pain mechanisms in behavior are subtle and priate tools for pain recognition underlying different conditions, and the cat’s natural are some of the reasons why behavior. It relies mostly on owner-assessed likely to be suppressed analgesic administration is com- behavioral changes and time-consuming veterinary monly neglected in cats.1 consultations. Beyond OA – for which disease- in the clinical setting. In chronic pain, changes in specific clinical signs have been described – little behavior are subtle and slow, and is known regarding other feline conditions that may only be evident in the home produce chronic pain.
    [Show full text]
  • Equine Health Studies Program 2008-2010 Equine Research Report
    Equine Health Studies Program 2008-2010 Equine Research Report Scientific studies conducted to help advance equine health and well-being LETTER FROM OUR DEAN The Louisiana State University School of Veterinary Medicine is pleased to once again present the Equine Health Studies Program’s Equine Research Report, which covers scientific activities of the program from 2008 through 2010. Central to the program’s mission is the health, well- being and performance of horses supported through state- of-the-art research that benefits the horse-owning public in Louisiana and beyond. As a former equine surgeon and faculty member, I have watched the EHSP grow and flourish, as evidenced by contents of this Research Report, translating research into practical solutions for our broad- base constituents and clients. In addition to its research prowess, the program’s dedicated faculty and staff provide clinical service, education, and community outreach. The EHSP has made significant advances in research collaborations with industry to extend its work in the areas of laminitis prevention; lameness, orthopedics and biomechanics; reproductive disorders; respiratory and gastrointestinal diseases including the treatment and prevention of gastric ulcer disease; equine Cushing’s disease; and surgery that will impact equine veterinary care for years to come. The EHSP continues to build and maintain strong relationships and community engagement with the stakeholders of Louisiana so that it can be responsive to the needs of horses in the region. In the aftermath of Hurricanes Gustav and Ike and the Gulf Oil Spill, the SVM was able to step in and help with the rescue and care of animals and wildlife in south Louisiana.
    [Show full text]
  • 268 Part 522—Implantation Or Injectable Dosage Form
    § 520.2645 21 CFR Ch. I (4–1–18 Edition) (ii) Indications for use. For the control 522.82 Aminopropazine. of American foulbrood (Paenibacillus 522.84 Beta-aminopropionitrile. larvae). 522.88 Amoxicillin. 522.90 Ampicillin injectable dosage forms. (iii) Limitations. The drug should be 522.90a Ampicillin trihydrate suspension. fed early in the spring or fall and con- 522.90b Ampicillin trihydrate powder for in- sumed by the bees before the main jection. honey flow begins, to avoid contamina- 522.90c Ampicillin sodium. tion of production honey. Complete 522.144 Arsenamide. treatments at least 4 weeks before 522.147 Atipamezole. main honey flow. 522.150 Azaperone. 522.161 Betamethasone. [40 FR 13838, Mar. 27, 1975, as amended at 50 522.163 Betamethasone dipropionate and FR 49841, Dec. 5, 1985; 59 FR 14365, Mar. 28, betamethasone sodium phosphate aque- 1994; 62 FR 39443, July 23, 1997; 68 FR 24879, ous suspension. May 9, 2003; 70 FR 69439, Nov. 16, 2005; 73 FR 522.167 Betamethasone sodium phosphate 76946, Dec. 18, 2008; 75 FR 76259, Dec. 8, 2010; and betamethasone acetate. 76 FR 59024, Sept. 23, 2011; 77 FR 29217, May 522.204 Boldenone. 17, 2012; 79 FR 37620, July 2, 2014; 79 FR 53136, 522.224 Bupivacaine. Sept. 8, 2014; 79 FR 64116, Oct. 28, 2014; 80 FR 522.230 Buprenorphine. 34278, June 16, 2015; 81 FR 48702, July 26, 2016] 522.234 Butamisole. 522.246 Butorphanol. § 520.2645 Tylvalosin. 522.275 N-Butylscopolammonium. 522.300 Carfentanil. (a) Specifications. Granules containing 522.304 Carprofen. 62.5 percent tylvalosin (w/w) as 522.311 Cefovecin.
    [Show full text]
  • Hospital Standards Self-Evaluation Checklist
    Hospital Standards Self-Evaluation Checklist July 2017 The Hospital Standards Self-Evaluation Checklist was developed by the Veterinary Medical Board (Board) and its Multidisciplinary Advisory Committee with input from the public and profession in order to assist Hospital Directors’ review of minimum standards to achieve compliance with the law. The Board strongly recommends involvement of the entire staf in a team efort to become familiar with and maintain the minimum standards of practice. Contents INTRODUCTION 1 GENERAL 3 1. After Hours Referral/Hospital Closure. 3 2. License/Permit Displayed . 4 3. Correct Address . 6 4. Notice of No Staff on Premises . 7 FACILITIES 9 5. General Sanitary Conditionsn . 9 6. Temperature and Ventilation. 10 7. Lighting . 10 8. Reception/Offce . 10 9. Exam Rooms . 11 10. Food & Beverage . 11 11. Fire Precautions . 12 12. Oxygen Equipment . 13 13. Emergency Drugs and Equipment. 13 14. Laboratory Services . 13 15. X-ray . 14 16. X-ray Identifcation. 15 17. X-ray Safety Training for Unregistered Assistants . 16 1 8. Waste Disposal . 16 19. Disposal of Animals . 17 20. Freezer. 17 21. Compartments . 18 22. Exercise Runs . 18 23. Contagious Facilities. 19 SURGERY 21 24. Separate Surgery . 21 25. Surgery Lighting/X-ray/Emergency . 22 26. Surgery Floors, Tables and Countertop . 23 27. Endotracheal Tubes . 23 28. Resuscitation Bags . 23 29. Anesthetic Equipment . 24 30. Anesthetic Monitoring . 24 31. Surgical Packs and Sterile Indicators . 25 32. Sterilization of Equipment . 26 33. Sanitary Attire . 26 Hospital Standards Self-Evaluation Checklist i DANGEROUS DRUGS/CONTROLLED SUBSTANCES 29 34. Expired Drug. 29 35. Drug Security Controls .
    [Show full text]
  • 001-017-Anesthesia.Pdf
    Current Fluid Therapy Topics and Recommendations During Anesthetic Procedures Andrew Claude, DVM, DACVAA Mississippi State University Mississippi State, MS • Intravenous fluid administration is recommended during general anesthesia, even during short procedures. • The traditional IV fluid rate of 10 mls/kg/hr during general anesthesia is under review. • Knowledge of a variety of IV fluids, and their applications, is essential when choosing anesthetic protocols for different medical procedures. Anesthetic drug effects on the cardiovascular system • Almost all anesthetic drugs have the potential to adversely affect the cardiovascular system. • General anesthetic vapors (isoflurane, sevoflurane) cause a dose-dependent, peripheral vasodilation. • Alpha-2 agonists initially cause peripheral hypertension with reflex bradycardia leading to a dose-dependent decreased patient cardiac index. As the drug effects wane, centrally mediated bradycardia and hypotension are common side effects. • Phenothiazine (acepromazine) tranquilizers are central dopamine and peripheral alpha receptor antagonists. This family of drugs produces dose-dependent sedation and peripheral vasodilation (hypotension). • Dissociative NMDA antagonists (ketamine, tiletamine) increase sympathetic tone soon after administration. When dissociative NMDA antagonists are used as induction agents in patients with sympathetic exhaustion or decreased cardiac reserve (morbidly ill patients), these drugs could further depress myocardial contractility. • Propofol can depress both myocardial contractility and vascular tone resulting in marked hypotension. Propofol’s negative effects on the cardiovascular system can be especially problematic in ill patients. • Potent mu agonist opioids can enhance vagally induced bradycardia. Why is IV fluid therapy important during general anesthesia? • Cardiac output (CO) equals heart rate (HR) X stroke volume (SV); IV fluids help maintain adequate fluid volume, preload, and sufficient cardiac output.
    [Show full text]
  • Veterinary Anaesthesia (Tenth Edition)
    W. B. Saunders An imprint of Harcourt Publishers Limited © Harcourt Publishers Limited 2001 is a registered trademark of Harcourt Publishers Limited The right of L.W. Hall, K.W. Clarke and C.M. Trim to be identified as the authors of this work have been asserted by them in accordance with the Copyright, Designs and Patents Act, 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without either the prior permission of the publishers (Harcourt Publishers Limited, Harcourt Place, 32 Jamestown Road, London NW1 7BY), or a licence permitting restricted copying in the United Kingdom issued by the Copyright Licensing Agency Limited, 90 Tottenham Court Road, London W1P 0LP. First edition published in 1941 by J.G. Wright Second edition 1947 (J.G. Wright) Third edition 1948 (J.G. Wright) Fourth edition 1957 (J.G. Wright) Fifth edition 1961 (J.G. Wright and L.W. Hall) Sixth edition 1966 (L.W. Hall) Seventh edition 1971 (L.W. Hall), reprinted 1974 and 1976 Eighth edition 1983 (L.W. Hall and K.W. Clarke), reprinted 1985 and 1989 Ninth edition 1991 (L.W. Hall and K.W. Clarke) ISBN 0 7020 2035 4 Cataloguing in Publication Data: Catalogue records for this book are available from the British Library and the US Library of Congress. Note: Medical knowledge is constantly changing. As new information becomes available, changes in treatment, procedures, equipment and the use of drugs become necessary. The authors and the publishers have taken care to ensure that the information given in this text is accurate and up to date.
    [Show full text]
  • Establishment Objectives
    Establishment The College of Veterinary Science & Animal Husbandry was established on 1st July, 2008 with the funding from the Chief Ministers’ Ten Point Programme (Vanbandhu Kalyan Yojana), Government of Gujarat with a total five year outlay for an amount of Rs. 62.62 crores under the flagship of Navsari Agricultural University by visionary Late Vice – Chancellor Dr. R.P.S. Ahlawat. The proposal for the new college was prepared by the day and night efforts of Dr. P.M. Desai, Late Dr. G. S. Rao, Dr. V.B. Kharadi and Dr. V.S. Dabas along with the help of other staff members. The college was renamed as Vanbandhu college of Veterinary Science and Animal Husbandry in year 2010-11 as the college is under Vanbandhu Kalyan Yojna. Veterinary College in the South Gujarat region caters the necessity of livestock farmers / owners and pet owners especially of tribal region of South Gujarat. The college building was inaugurated on January 1st, 2012 by Padma Vibhushan Dr. M.S. Swaminathan, in the solemn presence of erstwhile Hon. Min. Shri Dileep Sanghani (Minister, Agriculture and Co-operation, Gujarat state) and Hon. Min. Shri Mangubhai Patel (Minister, Forest and Environment, Gujarat state). The college building has been constructed in the 12000 Sq.Mt. area at the approximate cost of 14.5 crore. The college main building is divided in to five blocks, mainly ‘A block’ which is administrative building, B, C and D blocks, which has 13 departments and E block, which has four class rooms, two examination halls, a library room, an exhibition hall etc.
    [Show full text]
  • Effects of Alfaxalone Or Propofol on Giant-Breed Dog Neonates Viability
    animals Article Effects of Alfaxalone or Propofol on Giant-Breed Dog Neonates Viability During Elective Caesarean Sections Monica Melandri 1, Salvatore Alonge 1,* , Tanja Peric 2, Barbara Bolis 3 and Maria C Veronesi 3 1 Società Veterinaria “Il Melograno” Srl, 21018 Sesto Calende, Varese, Italy; [email protected] 2 Department of Agricultural, Food, Environmental and Animal Sciences, University of Udine, 33100 Udine, Italy; [email protected] 3 Department of Veterinary Medicine, Università degli Studi di Milano, 20100 Milan, Italy; [email protected] (B.B.); [email protected] (M.C.V.) * Correspondence: [email protected]; Tel.: +39-392-805-8524 Received: 20 September 2019; Accepted: 7 November 2019; Published: 13 November 2019 Simple Summary: Nowadays, thanks to the increased awareness of owners and breeders and to the most recent techniques available to veterinarians, the management of parturition, especially of C-sections, has become a topic of greater importance. Anesthesia is crucial and must be targeted to both the mother and neonates. The present study aimed to evaluate the effect of the induction agent alfaxalone on the vitality of puppies born from elective C-section, in comparison to propofol. After inducing general anesthesia for elective C-section, puppies from the mothers induced with alfaxalone had higher 5-min Apgar scores than those induced with propofol. The concentration of cortisol in fetal fluids collected at birth is neither influenced by the anesthetic protocol used, nor does it differ between amniotic and allantoic fluids. Nevertheless, the cortisol concentration in fetal fluids affects the relationship between anesthesia and the Apgar score: the present study highlights a significant relationship between the anesthetic protocol used and Apgar score in puppies, and fetal fluids cortisol concentration acts as a covariate of this relationship.
    [Show full text]
  • The Cardiorespiratory and Anesthetic Effects of Clinical and Supraclinical
    THE CARDIORESPIRATORY AND ANESTHETIC EFFECTS OF CLINICAL AND SUPRA CLINICAL DOSES OF ALF AXALONE IN CYCLODEXTRAN IN CATS AND DOGS DISSERTATION Presented in Partial Fulfillment of the Requirements for the Degree Master of Science in the Graduate School of The Ohio State University By Laura L. Nelson, B.S., D.V.M. * * * * * The Ohio State University 2007 Dissertation Committee: Professor Jonathan Dyce, Adviser Professor William W. Muir III Professor Shane Bateman If I have seen further, it is by standing on the shoulders of giants. lmac Ne1vton (1642-1727) Copyright by Laura L. Nelson 2007 11 ABSTRACT The anesthetic properties of steroid hormones were first identified in 1941, leading to the development of neurosteroids as clinical anesthetics. CT-1341 was developed in the early 1970’s, featuring a combination of two neurosteroids (alfaxalone and alphadolone) solubilized in Cremophor EL®, a polyethylated castor oil derivative that allows hydrophobic compounds to be carried in aqueous solution as micelles. Though also possessing anesthetic properties, alphadolone was included principally to improve the solubility of alfaxalone. CT-1341, marketed as Althesin® and Saffan®, was characterized by smooth anesthetic induction and recovery in many species, a wide therapeutic range, and no cumulative effects with repeated administration. Its cardiorespiratory effects in humans and cats were generally mild. However, it induced severe hypersensitivity reactions in dogs, with similar reactions occasionally occurring in cats and humans. The hypersensitivity reactions associated with this formulation were linked to Cremophor EL®, leading to the discontinuation of Althesin® and some other Cremophor®-containing anesthetics. More recently, alternate vehicles for hydrophobic drugs have been developed, including cyclodextrins.
    [Show full text]
  • Intravenous Alfaxalone Anaesthesia in Two Squamate Species: Eublepharis Macularius and Morelia Spilota Cheynei
    INTRAVENOUS ALFAXALONE ANAESTHESIA IN TWO SQUAMATE SPECIES: EUBLEPHARIS MACULARIUS AND MORELIA SPILOTA CHEYNEI Tesi per il XXIX Ciclo del Dottorato in Scienze Veterinarie, Curriculum Scienze Cliniche Veterinarie Dipartimento di Scienze Veterinarie, Universita’ degli Studi di Messina Tutor: Prof. Filippo Spadola Cotutor: Prof. Zdenek Knotek Dr. Manuel Morici Sommario L’anestesia negli Squamati è una costante sfida della medicina e chirurgia dei rettili. Le differenze morfo-fisiologiche di questi taxa, rendono difficilmente applicabile i comuni concetti di anestesiologia veterinaria usati con successo negli altri animali da compagnia. Diversi protocolli anestetici sono stati utilizzati, sia per l’induzione che per il mantenimento, sia negli ofidi che nei sauri, ma con risultati variabili. Di fatti la maggior parte dei protocolli risultano in induzione o recuperi troppo brevi o troppo lunghi. L’obbiettivo di questa tesi dottorale è di valutare l’efficacia di un anestetico steroideo (alfaxalone), somministrato per via endovenosa in due specie di squamati usati come modello: il geco leopardo (Eublepharis macularius) e il pitone tappeto (Morelia spilota cheynei). Due metodi di somministrazione endovenosa (vena giugulare nei gechi e vena caudale nei serpenti) sono stati analizzati e descritti, usando un dosaggio di anestetico di 5 mg/kg in 20 gechi leopardo, e di 10 mg/kg in 10 pitoni tappeto. Nei gechi il tempo di induzione, il tempo di perdita del tono mandibolare, l’intervallo di anestesia chirurgica e il recupero completo sono stati rispettivamente di 27.5 ± 30.7 secondi, 1.3 ± 1.4 minuti, 12.5 ± 2.2 minuti and 18.8 ± 12.1 minuti. Nei pitoni tappeto, il tempo di induzione, la perdita di sensazione, il tempo di inserimento del tubo endotracheale, l’intervallo di anestesia chirurgica e il recupero sono stati rispettivamente di 3.1±0.8 minuti, 5.6±0.7 minuti, 6.9±0.9 minuti, 18.8±4.7 minuti, e 36.7±11.4 minuti.
    [Show full text]
  • Veterinary Anesthesia and Pain Management Secrets / Edited by Stephen A
    Publisher: HANLEY & BELFUS, INC. Medical Publishers 210 South 13th Street Philadelphia, PA 19107 (215) 546-7293; 800-962-1892 FAX (215) 790-9330 Web site: http://www.hanleyandbelfus.com Note to the reader Although the information in this book has been carefully reviewed for cor­ rectness of dosage and indications, neither the authors nor the editor nor the publisher can accept any legal responsibility for any errors or omissions that may be made. Neither the publisher nor the editor makes any warranty, expressed or implied, with respect to the material contained herein. Before prescribing any drug. the reader must review the manu­ facturer's correct product information (package inserts) for accepted indications, absolute dosage recommendations. and other information pertinent to the safe and effective use of the product described. This is especially important when drugs are given in combination or as an adjunct to other forms of therapy Library of Congress Cataloging-in-Publication Data Veterinary anesthesia and pain management secrets / edited by Stephen A. Greene. p. em. - (The Secrets Series®) Includes bibliographical references (p.). ISBN 1-56053-442-7 (alk paper) I. Veterinary anesthesia-Examinations, questions. etc. 2. Pain in animals­ Treatment-Examinations, questions, etc. I. Greene, Stephen A., 1956-11. Series. SF914.V48 2002 636 089' 796'076--dc2 I 2001039966 VETERINARY ANESTHESIA AND PAIN MANAGEMENT SECRETS ISBN 1-56053-442-7 © 2002 by Hanley & Belfus, Inc. All rights reserved. No part of this book may be repro­ duced, reused, republished. or transmitted in any form, or stored in a database or retrieval system, without written permission of the publisher Last digit is the print number: 9 8 7 6 5 4 3 2 CONTRIBUTORS G.
    [Show full text]
  • 240 Part 522—Implantation Or Injectable Dosage Form
    § 520.2645 21 CFR Ch. I (4–1–14 Edition) feed; and for the control of porcine pro- (3) Limitations. Federal law restricts liferative enteropathies (PPE, ileitis) this drug to use by or on the order of a associated with Lawsonia intracellularis licensed veterinarian. when followed immediately by tylosin [77 FR 55415, Sept. 10, 2012] phosphate medicated feed. (B) For the treatment and control of PART 522—IMPLANTATION OR swine dysentery associated with Brachyspira hyodysenteriae. INJECTABLE DOSAGE FORM NEW (iii) Limitations. Prepare a fresh solu- ANIMAL DRUGS tion daily. Do not administer within 48 Sec. hours of slaughter. As indicated in 522.23 Acepromazine. paragraph (d)(3)(ii)(A) of this section, 522.52 Alfaxalone. follow with tylosin phosphate medi- 522.56 Amikacin. cated feed as in § 558.625(f)(1)(vi)(c) of 522.62 Aminopentamide. this chapter. 522.82 Aminopropazine. (4) Honey bees—(i) Amount. Mix 200 522.84 Beta-aminopropionitrile. milligrams tylosin in 20 grams confec- 522.88 Amoxicillin. 522.90 Ampicillin injectable dosage forms. tioners’/powdered sugar. Use imme- 522.90a Ampicillin trihydrate suspension. diately. Apply (dust) this mixture over 522.90b Ampicillin trihydrate powder for in- the top bars of the brood chamber once jection. weekly for 3 weeks. 522.90c Ampicillin sodium. (ii) Indications for use. For the control 522.144 Arsenamide. of American foulbrood (Paenibacillus 522.147 Atipamezole. 522.150 Azaperone. larvae). 522.161 Betamethasone. (iii) Limitations. The drug should be 522.163 Betamethasone dipropionate and fed early in the spring or fall and con- betamethasone sodium phosphate aque- sumed by the bees before the main ous suspension.
    [Show full text]